To date, what do we really know about psoriasis? Well, other than psoriasis being a red raised rash that is often covered with silvery-white scales, we know that it is a very stubborn and chronic skin problem. We know that is often genetically inherited, with children having a 30% chance of developing the disease if one parent has it, and between a 60-70% chance if both parents have it. We know that some patients will have very intense itching with their psoriasis, whereas others may have absolutely none, thus differing from eczema which has itch as its main trademark sign. But more than anything, the most important thing we know about psoriasis is that this condition is associated with a wide variety of other health complaints, including arthritis, diabetes, heart disease and depression, which thus shows that psoriasis is truly a systemic disease. Proper management of psoriasis must involve some type of internal medicine.

Differing from my previous post on psoriasis, which showed how topical herbal treatments can be good at alleviating psoriasis, I still believe that without internal medicines the disease will likely be hard to keep under control. The trick is finding the right medicine for the job. I recently started seeing a patient who had just finished a trial study on the effects of using an injectable biologic immune-suppressing drug to help control psoriasis. This was in fact the third study he had participated in, a process that had lasted over the past 7 years. The first two studies proved non-beneficial, with no clearing of his psoriasis observed, but on the last round of injections he actually cleared completely. Good right? An injection every month or so was able to completely eradicate his psoriasis and, for him anyways, there was no noticeable side effects (in the short term anyways).

The problem was that after about a month his psoriasis would soon creep back in. Basically his body could not keep the rash at bay without the drug. Similar drugs that are in use right now run about six thousand dollars per injection, with an average cost of more than thirty thousand dollars a year, for the rest of the patients life! Long term side effects aside (a fact that we simply do not understand very well yet with these newly designed drugs), the cost of these medicines are completely prohibitive to the average person, particularly to this fellow who was cut off from the free injections once the study had ended.

Last year I received a call from a woman in regards to her husband’s psoriasis. He was about 35 years old and together they had a couple kids. Apparently he had signed the waiver to try an ‘experimental’ drug program for his psoriasis, much similar to the above case I just mentioned, which allowed the man to receive his injections for free. A few months later his widespread psoriasis had disappeared but, also like the case above, the psoriasis would soon re-appear a month or two after stopping the injections. Unfortunately, this man’s case became worse, as he soon developed very severe pneumonia (a likely consequence of suppressing the immune system too strongly) and he was hospitalized. He had become very weak and lethargic. Blood tests revealed that this man had also become severely anemic, and so it seemed that the drug had stopped his body from being able to produce healthy amounts of red blood cells. Unfortunately I never heard back from the man’s wife, who was the one that had originally phoned in, so I do not know what happened after he was admitted to the hospital. I do hope he turned out ok and has bounced back into his previously strong self.

The treatment for psoriasis must involve internal medicines, so in this regard I think that these newer injectable medicines are stemming from the right thinking, but the medicines have to be deemed safe. They must show that they work, but they must not add extra health burdens upon the individual who ingests them. For me, the safest, most time proven, methods for safely alleviating psoriasis are through the use of Chinese herbal medicine. These herbs have generally been used for thousands of years, being administrated by thousands of doctors for many millions of patients. When properly administrated, side effects are very rare and usually only involve temporary changes to the digestive system, like a looser stool or more gas and flatulence. Unless the herbs themselves had been tainted with some toxic substance, extreme side effects like that mentioned above are very very rare. Let us all remember that dermatology in China is one of the oldest continuously practiced specialties in the world, with its first mention appearing in scrolls dating back to around 300 BC. Psoriasis, as a disease, seems to have been recorded at least by the 6th century AD, thus the Chinese medical system has certainly gained much experience when treating such complicated health problems.

My mentor, Mazin Al-Khafaji, who is well respected around the world for his ability to treat complex skin and autoimmune disorders using herbal medicines, has found, in his 30 years of treating many thousands of patients with psoriasis, that about 65% will clear completely. Upon a 3 year follow up, after stopping the herbal medicines, about 60% of those patients will still be clear. While not perfect, this is a much better statistic than anything I have seen with patients using western pharmaceutical methods. The great result is most likely due to the complex nature of the herbal medicines themselves, as they all contain many hundreds of chemical compounds that will work in their own unique way on the body, but even more importantly, these herbs are always made into a formulation that is entirely based on the individual, not just the disease. Chinese medicine doctors do not give every patient with psoriasis the same medicine. They create and change the formulation to match the person in front of them, which has been the way for thousands of years, and is truly a reason behind the great success of Chinese medicine for complex skin diseases.

The treatment of psoriasis accounts for about 30 to 40% of my current clinical practice, thus I am privileged to see a lot of it! Everyone is photographed to monitor their progress, which I do say is generally good. The 16th century scholar-physician Chen Shigong showed in his book, entitled ‘Wai Ke Zheng Zhong (An Orthodox Manual of External Diseases)’, that equal attention should be paid to internal and external therapies for skin diseases such as psoriasis, and this is exactly how I practice. All patients with psoriasis receive custom designed herbal formulations to drink, as well as special herbal pastes and creams that they apply directly to their skin.

Psoriasis is a systemic disease and needs internal medicines, particularly medicines that are safe. While herbal medicines are certainly messier to use, and do not taste as good as a western pill (or injection), they do have a long history of safe use, with many doctors proving that they do indeed work.

With over 2500 years of documented history, Chinese medicine dermatology is one of the oldest continuously-practiced specialities in the world. In our modern world, Doctors are using these ancient techniques, right alongside western pharmaceutical medicines in hospital setting all over the globe, to treat a wide variety of complicated and stubborn health complaints. While anyone who has the privilege and joy to witness the powerful effects that Chinese medicine can have on a patient, (like watching widespread psoriasis slowly – or rapidly – disappear through the use herbal medicines) will know, it is certainly a nice pat on the back when modern research steps in and confirms that yes, “You know that great work you and so many other doctors are doing with herbal medicine? Well, it seems to actually work”.

Improvement was evident … when topical herbal formula was compared to placebo. No serious adverse events were reported. Experimental studies reported that these herbs and/or their constituents have anti-inflammatory, anti-proliferative, anti-angiogenic, and tissue repair actions. These actions may at least partially explain the apparent benefits of the topical multi-herbal formulations in psoriasis.

Nice hey? Apparent benefits without any adverse effects. Especially good considering that many of the western pharmaceutic medicines used for the topical treatment of psoriasis usually include a steroid of some sort, which is well known to permanently thin the skin, leaving it more fragile and susceptible to future psoriasis flares.

Another interesting point the study raised was that many of these topical herbal mixtures contained the herb Lithospermum erythrorhizon root (Zi Cao), which is a herb I myself use quite often when I treat psoriasis. I use it both in pastes that are applied directly to the skin, and in teas that the patient will drink. When infusing this herb into an oil it creates the most beautiful reddish purple colour. I took a picture of the last batch of herbal infused oil so that you could all see what it looks like. Quite beautiful really, and even more so considering its powerful ability to help eliminate psoriasis!

Cigarette smoking is bad for our health. Period. We all know that smoking can lead to such terrible tragedies as lung cancer, stroke and heart attack, making smoking one of the leading causes of preventable deaths world-wide. What many people do not know very well, is that smoking is bad for the health of our skin as well.

Just look at the skin of a chronic smoker. It is often drier and full of wrinkles, making smokers look much older than they actually are. This is because the chemicals found in cigarettes damage collagen, which is the main connective tissue keeping our skin flexible, smooth and vibrant. Smoking also constricts blood flow so that proper moisture and nourishment is not able to saturate the skin properly, leaving the skin dry and withered looking. Impaired collagen production and poor circulation also leads to a decreased ability to heal from cuts and wounds, putting smokers at greater risk to suffer with stubborn infections.

Cigarette smoking also puts the immune system into a state of chronic inflammation, triggering off such skin diseases as psoriasis, atopic dermatitis, hand eczema, hair loss, acne and lupus. Nicotine in tobacco is an immune-suppressant, which means that smokers tend to have higher rates of HPV infections (warts), herpes, malignant melanoma and other skin cancers.

One study found that up to 95% of patients with psoriasis of the hands and feet were either active smokers or had smoked at some previous point in their life. The nurses study, involving more than 100,000 women over a 25 year period, found a 50% increase in skin cancer rates amongst those who smoked. When trying to treat such complicated skin condition as these, it seems imperative that the patient stop smoking, for even the strongest of medicines, and other positive lifestyle modifications, may have little impact.

Research has pointed out that the ill effects of smoking on skin health is not limited to just the smokers themselves, as those who are passively breathing in smoke can be affected as well. Children exposed to second hand smoke, either with the mother smoking cigarettes during her pregnancy or by someone smoking regularly in their home environment, have a much greater risk of developing, not only eczema, but other allergic diseases such as asthma and hay fever.

I have never been a cigarette smoker (probably because my own parents smoked while I was growing up and it drove me totally crazy) but I can imagine how hard it must be to stop such a strong addiction. That said, I do encourage all my patients who are serious about managing their skin disease to stop smoking and, it it proves too difficult to stop on their own, that they should seek out professional help.

Many of you use herbal medicines for help with a wide variety of health issues; from digestive support to the alleviation of intensely itchy eczema. This is good, and is the way it should be. Our bodies come from Nature and, as such, depend on Nature for health and nourishment. Unfortunately there are many so-called ‘herbal’ products on the market which, while claiming to be all natural, are of poor quality, contain many unnecessary fillers, the wrong species of plant, and may in fact be contaminated with not-so natural ingredients. These poor manufacturing practices degrade both the effectiveness and safety of herbal medicines, which ultimately means that you do not get better! The World Health Organization (WHO) declares that the adulteration of herbal medicine products is a threat to consumer safety.

Research published last year in BMC medicine used DNA barcoding to test 44 different manufactured herbal products readily available in North America, representing 12 companies, to see if the ingredients found inside the herbal product actually matched what was listed on the label. Roughly one third of the products tested contained contaminants, substitutions or fillers not listed on the label, some of which may actually pose serious health risks.

This news was not new to me. Before I myself studied Chinese medicine, I used to use an external cream called ‘999’, easily purchased from any China town pharmacy, which was said to be ‘all natural’ and good for itchy skin conditions. It worked great! I then learned that this cream contained a very potent steroid called ‘dexamethasone’, which can cause serious harm if over used. I was obviously very angry for being mislead and stopped using it immediately. Because of that experience, I now only prescribe herbal medicine products that I, or someone whom I trust, have personally prepared using high quality ingredients (best if from the actual dried plant itself).

I commonly see patients bringing home herbal products from India and China, many of which are most likely contaminated with ingredients not listed on the label. What we think is natural and safe may be far from it. Unless recommended by someone you trust, please be very careful when using any manufactured ‘natural’ product, as we really do not know what is truly in it. This goes for homeopathic medicines, as contaminates such as heavy metals and even pharmaceutical drugs are commonly reported in them as well. Seek out reliable sources.

Herbal medicines are powerful. I have personally seen them transform many people’s lives; turning dry, red and itchy eczema back into smooth healthy skin once again; regulating women’s delayed menstrual cycles back to 28 days; soothing the chronic diarrhea of an inflammatory bowel disease; and so much more! The effect of any herbal medicine product is, of course, only as good as its quality, so choose your medicines wisely. You deserve the great benefits that herbal medicines can deliver.

Have you ever wondered just how powerful herbal medicines really are, as in, ‘What can a plant, say much like the one growing in my garden, really do to help my skin?’ I mean, some skin issues are so crazy, so complicated and so very intense! How could some simple plant alleviate psoriasis, or eczema, or other issue. Aren’t these ‘automimmune’ diseases? Truly that is the work for ‘scientists’ working in laboratories to figure out… right? Well, I think you are going to enjoy what I am about to share with you.

First off, ask yourself this, ‘Do I question the power of plants, as food for me, my family, or any animals (like chicken, cows, Giraffes or elephants) in their ability to facilitate growth?’ Do I think I need to wait for the next scientific discovery before deciding what to make for dinner? Of course not, right. We instinctively trust Nature, and all its abundance. We trust that, being human, being a part of Nature itself, that food found upon this great Earth will indeed make us healthy, strong and nurtured. We would certainly be quite disappointed had we to spend 100’s of dollars at our next dinner night out at the fancy French bistro, only to find a plate full of blue, red and yellow tablets! I know I would be pretty upset, seeing as I totally love good food. Food that is fresh and beautiful. Food that was grown somewhere. Food that I have to actually chew!

How about, ‘Mom asked us over to her place for dinner tonight. Says she is going to mix up that CoQ10, Niacin, and L-Arganine dish again. You know the one with the nice orange Ester-C sprinkles on top. Apparently she got a discount at Walmart for the metamucil she uses as the bulking agent….’. Ugh! I’ll stick to my baked root vegetables thanks.

But surely medicine should be different. Treating disease is different than simply maintaining health. We need something really powerful to fight disease. Something developed by people working long hours in sterile laboratories, looking through microscopes at bacteria and viruses and, you know, all that deadly crazy stuff! Well, guess what? Plant based medicines, herbal medicines, have been the mainstay for the treatment of every imaginable disease, health issue, known to human kind since our earliest beginnings. Modern bio-medicine is barely 100 years old! In every culture around the globe, plant based medicines served as the primary, or only, method of directly tackling disease. We have records, both oral and written, of this long history.

Actually, the medicine of ancient China is still widely used all over the world right now in our modern day. Some estimates are that Chinese medicine represent the second largest medical system in the world. Hospitals outside places like China, Taiwan, such as Germany, Austria, Switzerland, and even the United States are embracing herbal medicines more and more as a primary method to treat complicated disease. Many western doctors are now learning Chinese medicine. They, more than anyone, have seen the limits that pharmaceutical based medicines can offer. Rather than seeing atopic eczema be merely suppressed with steroid creams, whereby the patient also ends up with severely weakened and thinned skin, whose eczema often flares up even worse as soon as the steroid is stopped (due to the well known re-bound effect), these doctors are witnessing the same result my wife noticed with her skin – that the eczema went away, went into long term remission, even after the herbal medicines were stopped. These doctors are noticing that herbal medicine, when properly prescribed, are working on the body in a much deeper way.

But it is not just the doctors noticing this, it is also the very people who design the drug medicines themselves who are noticing that herbal medicines, and particularly Chinese herbal medicines, are powerful tools to treat disease. In one of the most prominent journals for the discussion on drug creation, the British Journal of Pharmacology, I found the following quote in their december 2006 issue, ‘The development of systems biology has led to a new design principle for therapeutic intervention strategy, the concept of ‘magic shrapnel’ (rather than the ‘magic bullet’), involving many drugs against multiple targets, administered in a single treatment. Traditional Chinese Medicine (TCM) offers an extensive source of examples of this concept in which several active ingredients in one prescription are aimed at numerous targets and work together to provide therapeutic benefit.’ Clearly the folks making drugs are interested in a Tradition of medicine that is thousands of years old, whereby many tricks have been figured out. A medical tradition that actually works, really well.

(By the way, a quick search on the pubmed online research database using the term ‘Chinese herbal medicine’ reveals more than 16,000 threads, so clearly researchers are interested.)

But to be honest, I don’t think the drug companies will ever really figure things out. No matter how hard we try to re-create Nature, I think our efforts will always be secondary to the greatness of Creation itself. Some things, like herbal medicines, are probably best left alone, i.e., as plants. What needs to be encouraged is for people to continue their studies as to how to properly use herbal medicines, especially to treat issues like widespread psoriasis, or fiery red rosacea, or intensely itchy atopic eczema. It is not as easy as picking some dandelions from the curb-side, nor is it as easy as picking up a book and reading ‘ eczema = use this plant combination’, which is how a large portion of our modern medicine is practiced, AKA cookbook medicine, pick a disease, look it up in a book, and then prescribe a certain drug. Actually the ability to properly treat skin disease with Chinese herbal medicine demands much study, many years of it. In order to achieve the best results, the Doctor of Chinese medicine will create a formulation of 6 to 20 herbs, all in differing dosages, and all based on the individual it is meant to help. The possible combinations that can be made with Chinese herbal medicines are endless, which is why it will be really hard to duplicate it, so as to synthesis and mass produce something. The art really lies in the doctor’s ability to properly diagnose the individual before them, and then to make a custom herbal prescription to match.

Seeing as dermatology is the oldest specialty in the world, being seen as one since at least 300 BC or so, one would think that this particular medical art would need extra training. And really, I am ok with that. For the more time I take to study. The more time I take to fly across the world to train with my great teacher, Mazin Al-Kahafji, so as to see first hand the amazing work that he does, the more I come back inspired. The more confident I thus become, have become, to tackle the hard stuff. The more I am better able to look my patient in the eye and say, ‘Yes I can treat your psoriasis. Yes, I have done it before and I know it can work. It is not easy. It is not always perfect. It does not always work. But most of the time, as seen by the majority of my patients, a significant amount of clearing can be seen on the skin.’ And this, my friends, is all through the power of herbal medicines, which is pretty amazing.

Spring, for me, is the most beautiful time of year. Longer warmer days, flowers in blossom, green leaves emerging, insects buzzing, birds chirping – it is all so beautiful. However, this was certainly not how my wife, Gillian, experienced this time of year. When we first met, spring often meant an aggravation of the many allergic symptoms that she felt throughout the entire year. Actually, the spring and autumn months saw the return of the tissue paper pile next to the bed, as Gillian blew her nose all night long! All I can say is, ‘Good thing for Chinese herbal medicine”, as these really did change Gillian’s relationship to her environment.

Gillian, like many other people in the world, had what is called perennial allergic rhinitis, which is basically year round hay-fever that is triggered by everything from dust to animal dander to pollen to mould. Even temperature changes could be a trigger, going from a warm space to a cold one. Or even physical exertion. On top of the hay fever, Gillian also had asthma, widespread eczema, and hives (even anaphylaxis) to certain foods. She had the full blown stereotypical ‘atopic’ presentation, a state she inherited from both of her parents (usually a worse prognosis).

Most people manage their allergies through antihistamines, which may or may not actually work very well, and may actually make them feel rather ‘speedy’ or ‘dopey’, depending on which type they take. Some people start to rely on nasal sprays that contain small amounts of corticosteroids. All of this, of course, does not offer a ‘cure’ by any means, representing more of a long term dependency than anything.

So when Gillian started herbal treatment, initially for her eczema (which cleared very well), she eventually noticed that a lot of her other problems started to disappear. First was the roll of tissue paper, as it was no longer needed because her hay fever symptoms were gone. Then her asthma disappeared (except to cats, although the reaction was now greatly reduced), and many of her food allergies, including the dairy and eggs which previously gave her anaphylactic reactions in the past (I took Gillian on a holiday to Italy when we discovered she was free of those food issues). After stopping the herbal medicines, now 10+ years later, Gillian continues to have clear skin, clear breathing, no sneezing, itchy eyes, or runny nose, and she can enjoy a good tasting cheesy omelette. Gillian has to be careful with certain seafoods still, like salmon, and cannot be around cats for too long, but otherwise she is a completely different person, much less reactionary to her environment. The herbal medicines seemed to have healed the root issues as to why she was reacting in the first place, rather than just suppressing her symptoms.

Modern published research on the effectiveness of certain herbal medicines for allergic rhinitis has shown some interesting results. For example, one study using the herbal formula xin yi san for the treatment of allergic rhinitis found that, not only did the nasal symptoms reduce, an immune-modulating effect was observed in the blood tests drawn – which means that, rather than a patients symptoms being simply suppressed, as is how a steroid or antihistamine would work, a deeper curative effective may be achieved. Pretty cool hey!

Now I didn’t treat my wife, following in the golden rule of medicine to ‘not treat your family members’ (unless, of course, there is no other choice), and left all the healing decisions up to my first mentor, Dr. Wu. Watching Gillian heal, however, did motivate me to study Chinese medicine, and particularly to focus my studies on dermatology, allergy and auto-immune disease. Since I officially started practising Chinese medicine in 2005, I have now had the personal privilege to have helped many individuals and, like Gillian, I have noticed that most people find really good relief with Chinese herbal medicine.

Recently, an old patient, from 4 years ago, retuned to see me, not because he was suffering anymore, but because he thought he should come and let me know how well he was doing, and if there was anything he could do to keep himself feeling this way.

Basically, 4 years ago this gentleman appeared in my clinic suffering with the usual spring time upsets of runny nose, sneezing, and itchy eyes, and had become fed up with the dopey feeling that the antihistamines gave him. He responded very well to herbal treatment and continued taking herbal medicines off and on for about 2 years (through two allergy seasons). In the third year, he felt so good that he didn’t need to take anything, herbal or pharmaceutical, and lived a normal life enjoying the beauties that spring has to offer (I actually didn’t hear from him at all in the third year). Now it is the forth year since starting herbal treatment and he decided to come in for a check up which, as I said above, was really to show me how well he has been doing. It was actually from watching his neighbour suffer with hay fever that he was reminded of how bad his allergies used to be (easy to forgot the bad, when the problem is no longer a problem any longer!) Like my wife, his allergies seem to have become a thing of the past, thanks, of course, to Chinese herbal medicines.

While not obvious to everyone, how much you sweat, or not, is important in understanding skin disease. Sweating is our body’s method of venting off the excessive build up of heat and is a healthy means to keep our body in a balanced state of equilibrium. However, too much sweating, or not enough sweating, may actually aggravate a pre-existing disease, or even create a new one. Understanding how one sweats is important when diagnosing anyone with a skin disease, at least from the Chinese medicine point of view it is.

Think about it, if you sweat too much (particularly when you sleep), your skin will be left damp, possibly aggravating, or inviting, skin issues like eczema to flourish. On the other hand, the inability to sweat properly will leave the body greatly overheated, particularly the skin, which may then lead to the more drier forms of eczema. Since antiquity, Chinese medicine has placed great emphasis on the ability for a patient to sweat. If a patient suffers with eczema that is quite swollen, wet, and red, we may decide that this particularly patient suffers with a build up of pathological fluid, which may then be drained through the use of herbal medicines activating urination. If the skin is quite red, itchy, and dry, but the patient finds it hard to sweat, even though they may be totally overheating, then we could say that heat has lodged in the skin and has not been able to be properly discharged. Chinese herbal medicines may then be used to help open the pours so as to allow the heat to properly disperse.

It is also good to look at the type of materials worn against the skin, as many synthetic fibres may prevent the skin from breathing properly, thus allowing the skin to heat up unnecessarily. Cotton, flax and hemp are obviously the best to wear right against the skin, especially if you suffer with skin disease. This goes for overly thick moisturizing creams, such as vaseline which, while helping lock moisture in by creating occlusion, will also prevent the skin from breathing, particularly when it comes to sweating. Over use of vaseline is very common with patients, particularly with parents trying to help their young children. By smothering their children with too thick of moisturizer, the child may easily over heat, with their skin worsening and their mood turning into an agitated bomb shell!

Interestingly enough, the patient I saw today found this out all by their self. Several months ago this patient started developing a patch of eczema on their neck, for which they feared would spread to the rest of their body, particularly their face. As a preventative measure, this patient started slapping on creams (very similar to vaseline), with the thinking that this would help. On the contrary, the patient quickly worsened, with their entire upper body becoming very very inflamed and red. More thick moisturizer was applied, even more often, and the skin kept worsening, until one day this patient decided to just stop applying anything at all to their skin. Soon after, this patient experienced intense night sweats for several days, which was very unusual for them as sweating was usually non-eventful. The end result was that the majority of the redness dissipated and the eczema started to calm down all on its own. The thick moisturizing cream had blocked this patient’s natural healing method of clearing away excessive heat through her skin, allowing it to build up to the point of worsening their pre-existing eczema.

By understanding sweating, Chinese medicine physicians trained in dermatology can often help the most stubborn of skin conditions. Either by educating on the proper use of different moisturizing creams, or through the use of herbal medicines aimed at helping the body regulate any build up of unwanted heat and moisture.

In 2012, I had the opportunity to retake my dermatology diploma training in London, England, with Mazin Al-Khafji. Even though the cost of flying several times throughout the year from Vancouver to London was quite expensive; and even though I had previously finished at the top of my class when I first took the program back in 2007; and even though I have attained much clinical confidence in the treatment of various dermatological conditions (for which I am fortunate to use in my current clinical practice); I was very excited to train once again with Mazin. One of the reasons I was so excited (besides getting to be in the great city of London again) was because I knew that Mazin had updated most of his teaching material, which is entirely based on his own clinical successes (Mazin is one of the few teachers that I have encountered who only teaches on subjects he himself has had success with, thus the training is very practical and useful to the practicing clinician). This meant that when I studied acne, or atopic eczema, or psoriasis, again, I would get to see hundreds of NEW before and after photographs of Mazin’s case studies. When learning the art of dermatology, seeing is believing, and Mazin’s eye for detail is amazing to behold.

Mazin’s work is so amazing to behold, in fact, that I was amazed to once again realize how wide reaching his reputation for clinical success is. In the class there were students from all over the world (like me) who had flown in for the training, so as to be inspired by a true clinical master. Even more inspiring to me was the fact that a high percentage of the students in the class were themselves accomplished western medical physicians, including a western dermatologist, who had all seen the limitations of what pharmaceutical bio-medicine had to offer (first hand in their own clinical practices) and were now practicing Chinese herbal medicine. As one doctor and friend, Dr. Tanh Huynh from Zurich, Switzerland, mentioned to me, ‘seeing is believing and Mazin shows that herbal medicines work for the treatment of complicated disease. This is what is most important to me’. Tanh, a western medicine internal medicine specialist, now works alongside Mazin at the busy Avicenna clinic in Brighton, England. Tanh also runs the Chinese medicine hospital department at Seespital Horgen, Switzerland, flying back and forth between Zurich and Brighton on a regular basis so as to keep his foot in both busy worlds. It was through Mazin’s work, using herbal medicine to treat stubborn disease, that doctors like Tanh were inspired to do the same.

One of the greatest things I enjoy in my days spent with Mazin is our conversations together. Mazin is a caring and kind teacher who has, over the past many years, become a good friend. I value this more than anything. One of the greatest attributes I have seen Mazin display is his sense of humility. Literally thousands of people have overcome a life-long struggle with serious disease through the masterful herbal prescriptions that he has written over the past 30 years, which is truly amazing considering all the many other treatment modalities many of them had tried beforehand. To me this is extra-ordinary, being on par with super human abilities! But to Mazin, who shared with me one night over dinner, these acts of healing, which seem extra-ordinary, should really just be normal affairs. Mazin believes that the option for people to receive high quality care through Chinese herbal medicine should be made available everywhere, to everyone. This is at the root of Mazin’s heart whenever he teaches. Through sharing his own hard work, showing the audience what is actually possible, showing that even the worst cases of stubborn psoriasis, or acne, or eczema or rosacea, or colitis, or asthma, or any other stubborn health issue, can in fact be helped with properly prescribed herbal medicines, others are empowered to follow suit, thus elevating the standard of Chinese medicine, or health care, to the highest level possible.

For so openly sharing your hard work, for your dedication to excellence, for your constant encouragement that others can do the same (including myself), I am truly grateful Mazin. You have shown me a path for which is truly inspiring and very rewarding to follow. I, and all my patients that I have now helped, and continue to help, are extremely grateful for your kindness and overflowing wisdom.

One of the biggest concerns with acne is the scarring it can leave behind, especially since it is our very-visible face that is affected – an obvious reason why many people with acne also have a poor self-image. It may be interesting to note, however, that what many think is an acne scar may actually be something different. Let us explore…

Acne is basically a disease of the oil glands found in the face, back and chest, whereby keratin (the skin’s protein) and/or sebum (the skin’s oil) block the gland and create what is known as a comedone (white or black head). If these comedones become infected with bacteria, or other matter, they will turn into an inflammatory lesion called a papule or pustule (aka. pimple or Zit). Sometimes these inflammatory lesions may burst, usually by people picking at their zits, which can then destroy the surrounding tissue and, if it happens at the deeper dermis level of the skin, will create a scar. This is real scarring and is very hard to remove, especially with any type of herbal medicines, although I have heard that laser treatments for acne scar removal can be effective.

In the picture below we can see some ‘real’ acne scarring. The deeper layer of the skin has been damaged due to this person picking their pimples!

Now another thing that happens in acne prone skin is that the inflammatory lesion can concentrate melanin (the same pigment that gives us our summer tan) in that area, creating a brown spot. After the pimple clears up this brown spot stays behind, becoming what many people think is a scar, but is not a real scar at all. In fact this brown spot, called ‘post-inflammatory hyper-pigmentation’, will usually go away all on its own, but may just take awhile (upwards of 6 or more months). When people have lots of pimples that are constantly coming and going, they will usually have many of these brown spots coming and going as well, which gives the impression that they are always there as a permanent feature of their skin but, rest assured, these spots will most likely go away and are not a real scar.

In the picture below we see active acne, showing signs of comedones, papules and pustules, with hyper-pigmentation in the background.

Then below we have a picture of the same patch of skin as above, but after being treated for a couple months with Chinese herbal medicines. We can see that most of the inflammatory lesions are gone and that hyper-pigmentation remains in its place. This is not scarring and will most likely go away, with the skin eventually returning to its normal natural colour once again.

In Chinese medicine, brown discoloured patches of skin are thought to be the result of the blood becoming static after much heat has congealed it. Herbal medicines that improve the micro-circulation of the skin can often help resolve these brown spots more quickly and are commonly used at the end stages of treatment, after much of the inflammatory (hot) aspects are distinguished.

Healing from chronic skin disease can feel like a miracle when it happens. More so if one had already tried so many methods to overcome it, but nothing seemed to really work out. The creams tried for psoriasis worked a bit initially, but then stopped, leaving more fear of their potential side effects than anything. Eliminating the foods that the expensive blood test said were nasty ‘allergens’ created more paranoia as to what one can actually eat, whereas the eczema itself remained the same, or perhaps even worsened. Even the herbal remedy bought from the health food store, promising acne free skin, lead to nothing but diarrhoea! But then suddenly, a different strategy is tried and a miracle happens – the problem disappears. So what’s with that? What is this secret to healthy skin?

One patient told me several years ago, “I am still psoriasis free – not even one spot thanks to you, Mr. Miracle worker!’ But am I really a miracle worker? Did I somehow wave my arms in the air and make the river nile part before us? Certainly a nice gesture, and certainly a welcome compliment, but the reality is that the results this patient experienced were as a result of many years of hard study and clinical practice, an attempt on my part to follow in the footsteps of the many great physicians who paved the way before me. Chinese medicine dermatology is one of the oldest specialities in the world, dating back to at least 300bc. The collected wisdom of many thousands of years of clinical practice helped guide me in the decisions I made to help this patient, and everyone else I see. In reality, the miracle this patient experienced was calculated, the result of a medical system applied and seen true.

For me, there really is no ‘secret’ to healthy skin. There is no mysterious food to eat.. or not eat (although it can helps sometimes). There is no rare herb, found only on the top of Mount Everest, that will cure every and all diseases. Nor is there any chant or mantra or prayer that will suddenly make your rosacea go away. There are just basic principles that need to be considered when approaching any health problem, particularly when it comes to skin disease. I call these principles the ‘Three pillars of clinical success’:

The Patient

The Doctor

The Treatment

Patient: Successful treatment is, in part, related to the condition itself, as there are some diseases/ problems that are easier to treat than others, and even some that are simply not treatable at all (or not treatable using the current method being used). An experienced doctor will often understand this and will say so when offering advice. On the other hand, success is also related to the willingness of the patient to comply with treatment, which may mean modifying negative lifestyle habits and, of course, actually ingesting any medicine that a doctor may have prescribed (if one doesn’t try, then how does one know if it works or not?). The famous 17th century Chinese physician Xu Dachung warns us, however, that the tendency to blame the patient for an unsuccessful treatment is too high and that the doctor should look to their own skills first – a point for which I totally agree.

Doctor: The doctor must have sufficient training in the area of health that is of concern. They must be familiar with the condition/ disease being treated and, preferably, have lots of actual hands-on experience with its treatment. This often means being able to properly diagnose a particular disease, say psoriasis from basil cell carcinoma, or at least know when something looks weird enough to refer onto someone else for another opinion. In Chinese medicine it is then also important to understand why the particular disease is manifesting in the patient before them, as not everybody will manifest psoriasis or eczema or acne (or any other problem) in exactly the same way. We are all individuals, after-all, and so the doctor must take this into account when diagnosing and prescribing a treatment. The art of Chinese medicine lies in the ability for the practitioner to figure out what the imbalances contributing to ill-health are, and then to create an individualized treatment plan to restore health. The doctor’s theories must match reality. They must lead to the desired alleviation of the patient’s suffering, a feat made more plausible when the doctor is honest of their skill set and experience, having the courage to learn more when faced with challenges unfamiliar.

Treatment: The treatment has to match the problem needing help. It has to match the patient. It has to have a history of success, whether it be from good quality published research or, as is a foundational aspect of Chinese medicine’s long history, through the case studies of other practicing physicians. How did I know that herbal medicine would be best for my patient above, the one who experienced a miracle? I know this because I had seen my teacher display his own work, showing me that herbal medicine had been very effective in relieving many other patient’s psoriasis. Herbal medicines for psoriasis had been shown, to me as a doctor, to be effective, which was the first step of understanding a proper treatment strategy – ie. that the treatment matched the problem that I was wanting to treat. The second, very important, aspect here is that the herbal medicines used are of good quality. That they are fresh, are of the correct species, are at the proper dosage, and are cooked properly so as to ensure that all the necessary medicines are extracted from them. I regularly read on professional online forums of doctors finding that their treatment was unsuccessful for their patient. The doctor’s diagnosis seems correct, the disease is known to be treatable with the chosen treatment, the choice of herbs seems relevant, the patient is very compliant with their treatment, but yet no result. One possible reason could be that the herbs used were inferior, of bad quality, old, oxidized, or at dosages way too low, thus representing a waste of time, and money, really.

Of course at the end of the day, many people still do not get better. Not everyone is able to overcome their psoriasis, or eczema or acne, or whatever else that bothers them, even when all the above pillars seem to line up. Nature is not always so predictable and we must never hold on too rigidly to any one idea/ philosophy. However, the odds of success, of experiencing a miracle, will be greatly enhanced if one takes these pillars to heart whenever they embark on a journey to enhance their own well being. What is the responsibility of the patient seeking help? Is their condition even treatable? How experienced and knowledgable is the doctor? Have they actually seen people with similar problems repeatably improve? How proper is the medicine? Is it of good quality?

The herbal baths that Dr.Erikson prescribed for our 4 month old baby girl made a big difference! We saw a difference in her face within a week. She is now 5 months and her eczema has cleared almost 95%. Last couple nights she slept through 3-4 hrs, woke for feed and went back to sleep with no fuss, big difference from waking every 30 mins- 1 hr. We haven’t had to swaddle her either. She is still itching on some areas, but she is no longer constantly scratching herself and most importantly we no longer have to use the steroid creams regularly.

My husband and I were skeptical at first. However, we were desperate. Using steroid creams was not helping us control the eczema and the side effects made us felt uneasy. We saw three different doctors, all told us different things and continued to prescribed one steroid cream after the other. We were so sleep deprived because our baby was waking so often. When she is able to sleep, I would spend the time to research about eczema. Everything on the internet said to just moisturize and use steroid cream. I tried cutting out all foods that I thought could trigger her eczema. At one point I was just eating chicken and rice because I was so afraid her eczema would react. I was so desperate that I even tried to cut out rice to see if it made a difference. Then I became worried that she wasn’t getting all the nutrients. It was so frustrating. Bath time was so stressful for her and us. She would cry uncontrollably. We tried switching products after products, all did not make a difference. Finally my husband brought up the idea of using Chinese medicine because he knew my mom had made me drink a few herbal medicine after labour that seem to help me feel better. I went on the internet again and found dr.erikson’s story about baby boy and his mom dealing with baby eczema. It sounded exactly like what we were going through. Reading the testimonial, I thought maybe some of the babies coincidentally outgrew the eczema at the same time they saw dr.erikson. Even though I was skeptical, I saw that he was located in white rock, which is fairly close to home, I thought might as well give it a try.

After seeing Dr.Erikson for the first time, he told us to stop all lotions and steroid creams. Stopping steroid creams I understood, but was shocked to hear him say to stop applying lotion. I mean, moisturizing is the number one thing for eczema. He explained that we needed to just let our baby’s skin breathe and take a break from all the lotion that we were using. He gave us a cream which he said has nutrients for the skin and some herbs to boil and bathe our baby in. Within a week, we saw a difference on our baby’s face. It feels so good to see your baby play without having to constantly stop her from scratching herself. Bath time is now fun for our baby. She loves kicking and splashing the water. I’m so glad we don’t have to swaddle her anymore. She hated being swaddled and would always break free, but it was the only way to get her to stop scratching herself at night. We look at our baby now and still can’t believe her skin healed so quickly and feels so soft! Thank you Dr. Erikson! You have truly made a difference in our lives. – K. Thai

There has always been much speculation, at least on my part, that the overuse of antibiotics in young children will increase their tendency to develop eczema. While this has been my own clinical observation, without many thousands of cases to pool from, the data of one doctor’s experience will indeed be limited. Well, in the latest issue of the British Journal of Dermatology, a systemic review of 20 different studies linking the association of eczema with antibiotic use in children, found that early life exposure to antibiotics does increase the risk of eczema, with an increased risk of 7% for each additional antibiotic course received during a child’s first year of life. Thus the relationship is beyond suspicious, and now seems to be quite implicated and real!

Interestingly enough, I just saw a young 14 month old last week who was covered head to two in widespread weeping eczema. Quite a bad case for such a youngster. Upon investigation it became clear that he had a family history of the atopic disorder, with his mother, father, and sister all suffering with some type of eczema, asthma or hay-fever (all related problems). But this poor boy was clearly worse off than any of his relatives, leaving me with the question of why? Well it turns out that the boy had been suffering with chronic earaches since he was few months old, for which he had been put on antibiotics, one after another, with a total of at least 4 or 5 subsequent rounds – all of which coincided with a complete worsening of his eczema.

Basically we can say that the boy (which is true for most people) was born with a genetic tendency to have eczema. It doesn’t mean that he would have it for sure, it just means he had the genetic tendency to develop it at some time in his life. Certain triggers then allow that gene to be expressed. If the triggers are not removed, or continue in their intensity (as in the case of repeated antibiotic use), the eczema will flare in larger proportions and will also become more difficult to control. The trigger has to be stopped and the eczema must be calmed down, otherwise we end up with the eczema becoming a dangerous whole-body event.

So how would antibiotics lead to increased eczema? By looking through a Chinese medicine lens we may gain a few clues. It is well known that over use of antibiotics can lead to diarrhoea and loose watery stools, which is in part due to the drugs ability to wipe out all bacteria – both good and bad. In Chinese medicine we say that this type of bowel movement can be due to a break down of the digestion’s ability to separate out the clear (nutrition) from the turbid (the waste), with an accumulation of un-assimilated pathological fluids being the end result, which the Chinese have coined dampness. Dampness, when it accumulates, has a tendency to clog up the body, leading to such disorders as watery stools, arthritis, heaviness in the limbs, chronic colds and coughs, chronic earaches (research has shown that antibiotics are a poor long term solution for chronic earaches, probably because they actually worsen the fluid build up in the ear canal), thrush, and weepy types of eczema – for which this boy had.

Foods and medicines that are hard on the digestion may thus lead to dampness. Antibiotics seem to do this, as does excess sugar intake. I tell all my patients, especially parents of children suffering with dampness related illnesses like earaches and eczema, that they should greatly reduce their sugar intake, particularly in the form of refined white sugar (especially pop and candies!) but also fruit juice and floor products like cookies, bread and muffins.

When I treat youngsters, less than say 2, for such disorders like chronic earaches or eczema, I always try to do so by focusing on the reduction of sugary foods first. For the eczema I then try to rely on external herbal washes, lotions and creams. If these do not seem to be working, then I administer herbal medicines as a tea, which are made specific to the child’s needs. Much of the time these herbal teas are focused on improving the child’s digestion, as well as helping to facilitate their ability to rid themselves of excessive fluids, or dampness. This has been the way for thousands of years and thus proven as an effective means to conquer somewhat nasty problems. Let us remember that, while antibiotics are extremely powerful and much needed medicines, they are also relatively new in the grand scheme of things and, as such, we are still in the juvenile learning stages when prescribing them. Antibiotics, in my mind anyways, should thus be used as last resort when treating the young, undeveloped, and vulnerable. Best to first adjust the diet and stick to time proven herbal medicines, as prescribed by a trained professional, like a Doctor Chinese medicine skilled in the area of health that is of concern.

With the arrival of summer comes longer days, warmth and sunshine. A welcome gift for many of us living on the Canadian west coast, where winter months are full of many grey rainy days! The sun offers our best source of Vitamin D, an extremely important nutrient that can boost our immunity against colds and flus; improve our skin health; uplift our mood to make us happier; strengthen our bones; help regulate sugar and insulin; and improve fertility. The sun is surely a welcome friend, being as vital to our overall health as is water and vegetables.

Certain skin disorders, like psoriasis and seborrheic dermatitis, actually do better in the sun and so I usually encourage patients to get as much sunlight as possible on the areas of their bodies that are affected. Of course we need to use wisdom with our exposure by seeking shade during the peak hours – 11 till 3pm – and avoiding a sunburn, which may increase our chances of developing skin cancer later in life.

Some skin conditions, such as rosacea, lupus, melasma (chloasma), and vitiligo, can be negatively affected by the sun, so it is best to protect oneself if you suffer with such a problem. Light clothing, like a long sleeve shirt and a hat, offer the best protection. If a sunscreen is needed then it pays to read the label, as some ingredients, such as Oxybenzone and Retinyl palmitate, are controversial and may actually have damaging health effects. I think it best to avoid using products with such ingredients until conclusive evidence can prove their safety. Reliable sunscreens that are generally deemed safe are those that use minerals, such as zinc or titanium (non-nano sized), to create a reflective barrier on the skin’s surface. When using a sunscreen it is always a good idea to apply it frequently and liberally so that it can offer the expected protection it promises.

After sun exposure it is always a good idea to rehydrate the skin with a quality moisturizer. My personal favourite method is to apply pure organic aloe vera gel (at least 99%), which I keep cold in the fridge, liberally to all the areas of my sun exposed body – especially my face. Aloe vera has a long history of use all over the world, being esteemed for its ability to rehydrate and rejuvenate the skin. Studies have confirmed that aloe vera is very effective at healing the skin from any type of burn, particularly those caused by solar UV radiation. Once the aloe vera has air dried on, I then like to apply a moisturizing cream containing shea or cocoa butter as the base. Both oils are saturated vegetable fats that help lock moisture into the skin, while also offering good nutrition for proper skin health.

A while ago a man came to my clinic presenting with a strange red rash, which was present on only one side of his body, and was intensely itchy. Previous doctors had told him he simply had eczema and, as usual, prescribed him steroid creams and antihistamines in the hopes that his condition would subside. Unfortunately nothing seemed to help and so the itching continued on. By the time this patient came in to see me he had been suffering for 2 years already.

Upon investigation it became evident that the itching started upon his return from a vacation in India. He mentioned receiving a nasty mosquito bite on his forearm, from which left no rash to speak of, only intense itching. The itching continued and over the course of a year and a few months red bumps started appearing in the area where he scratched, as well as much dryness, for which moisturizing creams could not help. The man was otherwise healthy and had not suffered with skin disease at any other time in his 50+ years of life.

My diagnosis for this man was Lichen simplex, often known in Chinese medicine as niu pi xuan (Ox skin dermatosis), which is an extremely itchy skin condition that is often self perpetuated through constant scratching. It is usually only found in areas of the body that can be reached by scratching, and is often only one sided, thus differing from other itchy conditions like eczema or psoriasis which will tend to manifest symmetrically on the body. The origin of the itch can be from stress, nervous habit or, as in the case I present here, a simple mosquito bite. The need to alleviate the itch through scratching perpetuates the itch itself, leading to dryness of the skin and the appearance of an actual rash which may not have been present before. So in a way, lichen simplex is a self induced condition, as it is due to repeated bouts of scratching that deteriorate the skin and creates more itching – thus called the scratch-itch-scratch cycle.

In order to alleviate the lichen simplex one must then stop scratching. The cycle must be broken. I decided to give this man a lotion that I hand-make here in the clinic which uses such anti-itch medicinals as peppermint oil and calamine (a medicinal mineral). He was to apply the lotion 6, or more, times per day, or basically whenever he felt itchy. We wanted to try and stop the scratching cycle so that the skin could heal itself. I decided to not give any internal medicines at this point, as his condition did not seem too severe to me, and I felt rather confident that the lotion would suffice. Sure enough, over the course of a couple weeks his rash disappeared and his itching subsided.

This was his update to me:

“Dr. Erikson, I just want to update you since my appointment 2 weeks ago. The lotion you provided has worked very well in decreasing the itch and as a result my rash has completely cleared up. I was not expecting such quick results after having this for almost 2 years and am very pleased with the outcome to date. Thanks again.”

As many of my teachers of Chinese medicine have pointed out, “the right diagnosis leads to the right treatment, which then leads to the right outcome.”

Chinese medical dermatology represents one of the oldest continuously-practiced specialities in the world, with records describing doctors as trained skin specialists since at least 300 BC. Much experience has thus been gained over these past few thousand years, allowing doctors to offer herbal treatments that are both effective and safe – a major reason why it is now practiced in hospital settings all over the world, right alongside western medicine. I know this first hand because many of the doctors I trained with in England, while finishing my dermatology training, were western trained physicians – from countries like Belgium, Germany, Austria and Switzerland – who had switched over to herbal medicines as their primary treatment choice. These doctors saw first hand the limitations of pharmaceutical medicines and, like me, are now using herbal medicines with good success to treat such complicated disorders as psoriasis, eczema, rosacea, acne, and much more.

“Whenever those in the state are afflicted with illnesses, with ulcers on the head or with wounds to the body, he [the chief physician] visits them, and then sends to them physicians with an appropriate specialty to cure them.” –Rites of Zhou, 300-200 BCE (Translated by Nylan, M. (2001). The five Confucius classics. Yale University: New Haven, Connecticut)

Anyone who has suffered with skin disease, or has tried to treat it, knows first hand just how difficult it can be to overcome. For some people merely avoiding certain allergic foods may improve their situation, while for many others changing the diet does little to alleviate their problem. Steroid creams may offer relief in the initial stages of a skin flare, but are actually a poor long term solution, as their side effects can do more damage than good. Thus the time tested methods of properly prescribed herbal medicine serve a very good place in the management of skin disease.

This past autumn I was visited by a young woman who had been suffering with terrible eczema all over her body for many years. She had tried eliminating many foods in her diet and had used many different kinds of vitamin supplements, but unfortunately she found no relief. The itchy rash was disturbing her sleep and lowering the quality of her life. She didn’t know what else to do except to go back to using steroid creams, which she did not want to do. From a Chinese medicine perspective this woman’s particular skin problem was due to deep-seated heat in her blood, which needed to be cooled through the use of a specially constructed herbal medicine formula. Within a few weeks her skin was virtually clear, for the first time in years. Her itch was gone, her sleep was better and her outlook on life had become very positive. I kept her on herbal medicines for another couple months so as to help prevent the eczema from coming back. Many months after stopping, she happily reported back to me that her skin was still clear.

Eczema on the upper back

Eczema clear after herbal treatment

When it comes to managing skin disease everyone needs options that are safe and effective. With such a long history, herbal medicines are a good choice, but are best used through the guidance of a registered practitioner who, like the doctors of ancient times, has received specialty training in dermatology.

Many have to come to know me through the various writings and webinars I have published, which is certainly a big aspect of my work as a Doctor (the educating part), but this is really quite small in relation to the time and dedication I put into my clinic. My mentor, Mazin Al Khafaji, always reminds me that my main work is in the clinic, with patients, not rattling off fanciful theories and such. What this means is that the results my patients experience, or do not experience, are of top priority (seems obvious right?). Thus I have to pay close attention to every detail of a patient’s journey with me, especially to the aspects that I have direct control over, like the herbal medicines they consume (my most important contribution when treating such chronic and debilitating disorders as atopic eczema and psoriasis).

After diagnosing my patients, through a very thorough examination under strong bright lights and a detailed taking of their general health history, the creation of a herbal formula becomes paramount. Such herbal prescriptions have been written for thousands of years and are the mainstay of most Doctor’s practicing Chinese medicine. The first step is in relation to figuring out what herbs to choose, as well as their relative daily dosages (I have roughly 250+ herbs on hand at my clinic). The second step is in insuring the medicine prescribed is of good quality. No matter how well the diagnosis and herbal formulation is, if the herbs are not fresh and of a high standard, the patient may receive very little benefit.

As I wrote about in my previous blog on herb quality, I spend a lot of time trying to source out good quality herbal medicines. I want fresh and I want herbs free of contaminants like pesticide residues, heavy metals, etc. (I am currently using herbs from Spring Wind). In the picture below we can see an example of two different quality grades for the herb Yi Mu Cao (aka. Motherwort). It seems fairly obvious that the one on the left is of the superior grade, as the vibrant green and yellow colours just speak of freshness. Compared to the one on the right which is brown and dull looking, and is representative of common herbs bought out of a China town market. These two samples of course smell much different, with the one on the left having a somewhat sweet and aromatic quality, and the one on the right smelling musty and somewhat mildewy.

Now the kicker, the higher quality herb is more than twice the wholesale price as the poorer quality one. Thus if one was trying to save money, cut a few corners and make a bigger profit, poor quality herbs are very appealing. The cost, of course, will be in outcome. Not only will the poor quality herb struggle to achieve its promised effect (I often use Yi Mu Cao in formulations when it is clear that a woman’s skin issue flares up pre-menstrually), but the herb may in fact make a patient sick! Herb quality is well worth the extra price tag – for sure!

So again, check around. Make sure the herbs you are taking (patient) or prescribing (doctor) are of good quality. I am sure that the desired result will be much better for all.

This is an important point. Herbal medicines, no matter how expensive they are, or who they have been prescribed from, are probably useless unless they are of good quality and, of course, the correct species – thus representing that fine line between success and failure. In this article I share a bit of my own personal exploration in running a herbal pharmacy, and the responsibilities that come along with it.

Herbs can be a powerful tool for healing, and are used as such by doctors all around the world right in hospital settings, but their ability to evoke positive change is greatly influenced by their quality – i.e. freshness, harvest time, how they were dried, how they were stored, pesticide use, and correct species. Learning about the quality of a herb is as much important as it is to learn how to prescribe it properly. Unfortunately most doctors of Chinese medicine do not learn very much about this in college, mostly because there is only so much time one can study in school and the amount of knowledge needed to practice medicine is already quite large! Learning how to source out good quality herbs has been a big journey for me, and will be one that will probably last my entire career.

My mentor, Mazin Al-Khafaji, takes the issue of herb quality quite seriously, having helped his in-clinic pharmacist to attain a masters degree in the very topic of herb identification and quality. Upon my last visit Mazin had just received about 8 tonnes of herbal medicines and so him and his pharmacist were going through all the samples to ensure that they were good. Mold was found on one of the herbs, fang feng, and so they made the decision to throw all 200 pounds of it out. Mazin only wants quality herbs in his clinic and so there is no room for mold! I have learned a lot from Mazin’s example.

A few years ago I started making creams and ointments for my patients, one of which was the very old traditional recipe called Run Ji Gao (Moisten the flesh ointment). One of the prized herbal ingredients in it is Zi Cao (Arnebiae Radix), which literally translates as ‘purple grass’. I thus started ordering in several pounds of Zi Cao, which I then fried in sesame oil for the creation of the ointment. The finished product looked quite nice, being a very creamy white colour. I felt happy with it … until I told my mentor Mazin about the ointment. He said to me that Run Ji Gao is supposed to be purple, a reflection of Zi Cao’s purple pigment dying the sesame oil. Mazin informed me that I had probably received the ‘fake’ Zi Cao, which is actually a form of potentilla called wei ling cai. While it has some similar healing properties to the ‘real’ Zi Cao (Arnebiae Radix), its ability to heal inflamed skin is thought to be much inferior in action.

I thus went to the books to study and learn about how this could happen. Why did I end up with the wrong herb? Well it seems that there a several reasons for herbal ‘fakes’. One is for pure financial purposes, if someone can make good money off of an imitation fake herb, then they will try. The second reason, which is what happened to me with Zi Cao, is that herbs from different regions of China will share the same name even though they are totally different plants. Thus Zi Cao in the Hong Kong market, or the south of China, is often potentilla, whereas Zi Cao in Beijing, the north of China, is arnebiae. The materia medica, or herb encyclopaedia used in Chinese medicine, comes from the north, so all the plants that I use are based on northern standards of labelling. I later learned that when ordering Zi Cao from that particular supplier (who is based in Hong Kong) I need to ask for Hong Zi Cao, or ‘red purple grass’, if I wanted the arnebiae version.

So then I started ordering in the ‘real’ Zi Cao and was amazed at the beautiful colour it turned the sesame oil (see picture below). I was very happy indeed. The ointments made from this oil have served my patients very well, with most everyone being happy with the results they experience.

Now that I had figured out the correct species to use in my clinic, I was then confronted with another issue – herb quality. From time to time I started receiving Zi Cao that smelt somewhat mildewy and looked rather depleted and old (Picture below). This obviously made me somewhat upset, as I knew that good results with herbal medicines are related very much so to good quality. So I then realized that I couldn’t always count on that certain supplier to get me good quality herbs. I thus started using other suppliers, including Spring wind herbs out of California. The quality that I now order in is indeed very high. The herbs consistently smell and look good, with even my wife noticing the differences between the two.

Poor quality Zi Cao which was old, depleted and smelt of mildew!

Good quality Zi Cao (from Spring wind herbs) that is vibrant and fresh looking (and does not in any way smell mildewy!)

To keep stock of rare medicines used for particular specialties, like dermatology

As one can see from my own journey in wanting the best herbs for my patients, this advice holds true today as much as it did 250 years ago! Ensuring patients receive the proper herb species, that is of good quality, is an important responsibility of any physician prescribing herbal medicines.

Stumbling through various health blogs, magazines and health symposiums, we are often bombarded with a wide variety of ‘health experts’ advertising their products or services. This, of course, includes Western Doctors, pharmaceutical companies, vitamin supplement companies and, as well, Naturopaths, Homeopaths, Chiropractors, Doctors of Chinese Medicine, and so on. It can often be quite hard for the average person to know what will actually work for them, with the decision made even worse when claims that a product or service achieves a ‘100% cure rate’, or a ‘95% success rate’ are made. Wow! What to do? Could these claims be true? 100% cure for all disease? Well, I will tell you what I would do, I would run away as fast as I could!

See, the thing is, the human body is incredibly complex. Every person has their own unique constitution that will manifest any troubles, i.e. disease, in its own unique way. What may work for one person, may make another person worse, and unfortunately some people may not actually get better at all. Claims that 100%, or even 95% or 90%, of people are cured from their problem, any problem, are just plain ridiculous. Rather than develop faith in a given treatment, such claims actually make me more skeptical.

One of the great Fathers of Chinese medicine is considered to be Zhang Zhong Jing, who wrote a couple texts 1800 years ago entitled the Shang Han Lun (Treatise on Cold Damage) and the Jin Gui Yao Lue (Synopsis of Prescriptions of the Golden Chamber) – both of which are considered masterpieces for clinical practice and have influenced many generations of physicians throughout the ages, including this present day. In the introduction to the Shang Han Lun, Zhang Zhong Jing writes, ‘Although this book cannot completely cure all diseases, it provides the means to understand the origin of illnesses encountered. If [the reader] follows the materials herein collected, [he should be able to] think out over half [of all medical problems].’ In that passage we can see one of the reasons that this text has been such a grand source of inspiration for so many hundreds of years – Zhang Zhong Jing’s humility. He knew that one cannot treat everything, and everyone, successfully. He knew that such claims are simply impossible and so did not even pretend to promise such things.

To my knowledge, Chinese medicine represents the second largest medical system in the world. It is practiced in major hospitals throughout Asia, and even Europe, right along side Western medicine. I personally have colleagues who are trained Western medical specialists who are now using Chinese herbal medicine as their primary treatment tool. They do so because they have seen tremendous results. They, like me, have seen many an individual (suffering with debilitating diseases such as psoriasis, atopic eczema, or even rheumatoid arthritis) become symptom free while taking properly prescribed herbal medicines, and even after stopping them. Doctors all around the world know that herbal medicine is a very powerful tool to treat disease and relieve suffering, but most know that the results are certainly not 100%, and are thus humble in their achievements.

In my own clinical practice of medicine I have noticed that certain disorders tend to respond to treatment better than others, which means that the overall success rate is most definitely related to the disease being treated, just as much as it is to the individual’s own unique constitution. For example, we can look at two different blistering disorders seen on the hands. Hand eczema, or pompholox eczema, tends to respond very well to herbal treatment (particularly when the patient also learns to take care of their hands). My Mentor, Mazin Al-Khafaji, has said in the past that he has found roughly 80% of patients with pompholox eczema overcome this stubborn problem, which is similar to what I see in my own clinical practice. But contrast this to something like pustular psoriasis ( some doctors think this is not really a form of psoriasis, but something else), which can look quite similar to the untrained eye, I myself have found a very low rate of success – perhaps only 20% or so (this could be related to many things, including: difficulty of the disease, availability of certain key herbal ingredients, my own skill level and experience). I would be extremely leery of anyone claiming they get a 100% cure rate with pustular psoriasis, as it is certainly a very stubborn and recalcitrant problem.

So basically we have different ‘success rates’ for different diseases. Personally, I am always cautious to use the word ‘cure’, as this represents a ‘forever’ disappearance of one’s problem. Rather, I like to say that we are trying to knock the condition into deep remission, with the hopes that it never comes up again. Gillian, my wife, was treated very successfully with Chinese herbal medicine for her atopic eczema, seeing her 22 year long itchy plague clear 100%. This effect lasted for a good 10 years after stopping the herbal medicines. But then when my son was born in 2011, a little bit of eczema came back up on her arms, most probably due to the stress of birthing a premature baby, as well as having to use the strong alcohol soaps at the hospital. Her skin quickly cleared after the stress settled down, stopping the use of the strong soaps, and with the help of a one of my ointments, and has now been clear again for the past year. So while I originally thought that Gillian was cured of her eczema problem, 10 years without any skin issue, I now understand that the disease was knocked into remission. Gillian still caries with her the tendency to have eczema, and probably always will, but herbal medicines (and some lifestyle adjustments) have helped her live a very normal life for many years.

So again, when is it a good idea to run away from that booth at the health fair? When you see two words being used together – 100% and cure. No matter how convincing the treatment may appear, I do not believe there is a 100% cure rate for any and all diseases. This is absolute foolish talk!

With a home-based clinic, a large yard and a love of gardening I am often asked by patients if I grow the medicines that I prescribe for them. Oh how I wish! The reality is, of course, that the amount of herbs I use in a given year is far too large an amount to even consider growing here at home. I simply do not have the space, nor the time, and so I leave this up to the experts – the farmers who make their living by supplying the international herb market. Many of these farmers have long family traditions of growing, or wild crafting, herbal medicines and have thus learned a few tricks along the way, including important information about the proper harvesting and drying of these precious medicines.

I myself do have a long history with gardening, first inspired by my grandparent’s (on both sides) garden, which was often full of veggies, fruit and nuts. My parents also kept a garden of some sort while I was growing up, usually a combination of veggies and landscape ornamentals (my mother loves flowers). That young handsome boy in the picture there, tilling the Earth in prep for seeds to be planted, is me at age 5.

When I first studied western herbal medicines in 1991, I was so inspired by my teacher, Dr. Terri Willard’s, stories of living in tents and teepees in the interior of B.C., whilst wildcrafting herbal medicines, that I soon found myself doing the same. By the time my daughter was born in 1995, I was growing most of my family’s food whilst living in various earthen structures (including a teepee and log cabin) in the small village of Argenta at the North end of Kootenay lake. I was also harvesting what ever wild herb I could get my hands on, having a kitchen full of mason jars full of dried specimens.

Below is a picture of a very hairy Dr. Erikson in front of his garden in Argenta, 1996.

When I made the decision to study Chinese medicine and moved back down to Vancouver (leaving Natural paradise in search of deeper Doctoring skills), I quickly became involved in various gardening projects around the city, including the famous Strathcona community gardens near China town. I eventually started my own landscape company, using only hand tools and organic methods, to help pay the way through those initial 5 years of my Doctor of Chinese medicine training. I had huge dreams of growing the medicines I would prescribe to my patients, as it was something that seemed so natural for me to do. But once I started practicing Chinese herbal medicine, becoming busy with many patients, I soon realized that my romantic ideas of supplying my own clinic with herbs that I had grown and collected myself was not going to happen. I simply use too many herbs, and the time and space to grow them was just too big.

Dr. Trevor Erikson planting one of the veggie gardens he kept while being a student of Chinese medicine

Of course this doesn’t mean that I will not grow many herbs for my own family usage or even just for show, as many Chinese herbal medicines are actually very beautiful plants to have on the landscape. Herbs such as red and white peonies (Bai and Chi Shao Yao), forsythia (Lian Qiao), honeysuckle (Jin Yin Hua), trumpet flower (Ling Xiao Hua), rugosa rose (mei gui hua) and celosia flower (Ji Guan Hua) are herbs that I prescribe all the time, that also look fantastic in the garden. So I do plan to grow these ones, including many others. (For anyone interested, Richters seeds in Ontario carry both seeds and plants for many Chinese herbal medicines.) My dream is to make the garden both beautiful and functional, being loaded with edibles, medicinals and fragrant flowers to pick for the dinning room table.

I will also likely follow in my mentor Mazin Al-Khafaji‘s footsteps, as he does grow a few things at his clinic to treat patients. One of the herbs he grows is Chinese impatiens (Feng Xian Hua), as these flowers are a fantastic remedy for nail fungus and is best used fresh (basically ground up fresh and then painted onto the nails), thus the dried plant would not do. Another herb that Mazin is growing in his garden is Bai Ji (Rhizoma Bletillae Striatae), which is now an endangered species due to over harvest in the wild. When used in creams to help with the repair of dry, damaged and cracked hands (a wonderfully effective remedy), only a small amount is needed, thus it is a good one to grow for both practical and conservational purposes.

Out of concern for safety, high quality herbal medicines that are grown without pesticides (and other junk) is becoming quite popular. Spring Wind herbs from California is dedicated to providing herbs that are tested to be free of over 300 different pesticide and other contaminants. They encourage and support farmers to grow certified organic herbal medicines, thus helping to raise the bar in regards to quality and safety. With Chinese medicine representing the second largest medical system in the world, the demand for herbal medicine is forever growing. North American farms are thus sprouting up that are dedicated to providing locally grown Chinese herbal medicines including, for example, High Falls Gardens in New York state.

The coolest thing that I love about Chinese herbal medicine is that the whole practice revolves around nature – Earth, farmer, doctor, patient. Now with so many great herbal growing projects going on in the world that seem trustworthy I can relax my tendency to do everything myself, to be the Doctor growing all his patient’s medicines, and focus on the simpler aspects of gardening, raising my family and practicing Chinese herbal medicine.

“I would highly recommend Dr. Erikson! His ability to listen and his caring manner were qualities that I appreciated during each of my visits. After trying many different traditional and naturopathic remedies, I decided to see Dr. Erikson in the hope that he could help me. When I first saw him, I was suffering from ongoing problems with eczema. Since starting his specially made herbal tea, I have seen drastic improvements. In fact, it has virtually disappeared over the past 15 weeks. Thank you so much Dr. Erikson!” – NM

What could be worse for a child than to have the Chicken Pox during Christmas time – Right!!?? Well that was exactly what happened to me as a youngster (see that photo – Yes that’s me :)). I so remember that tormenting itch – Oh the agony! Chicken Pox at Christmas time! Man-o-man, of all the luck! But like many things in life, out of despair came wisdom, as it was during that nightmarish holiday that I was exposed to the power of herbal medicine – Calamine. My loving mother completely smothered me in the stuff and, while seemingly ridiculous at the time, it did really help – quite a lot actually. Who would have guessed that, years later, I would now be using the same stuff in lotions that I hand make for my patients. Calamine is most definitely an effective herbal medicine used extensively in Chinese medicine dermatology.

So what is Calamine anyways? It is actually a mineral, called Smithsonite, which is mainly composed of zinc carbonate and ferric oxide. Western medicine has been using it in a liquid suspension since the early 1800’s as a soothing, anti-itch, astringent lotion for insect bites, poison ivy, Chicken pox, eczema, and the like. In Chinese calamine is known as Lu Gan Shi (Stove sweet stone), and seems to be first mentioned in the Wen dai ben cao (Materia medica for external elixirs) written during the song dynasty (960-1279 AD), thus having a long recorded history of use. Today it is widely used in hospital settings throughout the world for helping to dry up damp sores on the skin, generate new flesh (the protective barrier it creates on the skin helps to regenerate new skin underneath), and for stopping itch.

I make a lotion that contains 10% finely ground and sifted calamine, that is based on an old empirical Chinese medicine formula, and is similar to one used by dermatologists around the globe. The lotion itself contains several herbs, including peppermint oil, which is another good anti-itch medicine. My patients find that it is very good at helping to cool down very red and inflamed skin, while also relieving itch (usually within a few minutes). They will usually follow this lotion with a good quality moisturizer so as to counter the overly drying effects of the calamine.

So when people ask me how did a white guy from the suburbs of Vancouver decide to become a Chinese medicine herbalist, I guess I have my Mom to thank. So thank you Mom for exposing me to the power of herbal medicines, especially Calamine!

When a patient starts treatment with Chinese herbal medicine, I am often asked if their skin will worsen before it improves. While the so-called healing crisis may be a commonly held belief within other healing modalities, it is not one that I am looking for. The idea that the skin will worsen before it gets better seems to be rooted in the idea that, as the body eliminates toxins, aggravation of symptoms will be witnessed. Many patients have told me that this had happened to them after trying other ‘natural medicine’ approaches. The problem is that, in more times than not, their skin never actually improved after the healing crisis. Plain and simple I want to see my patient’s skin improve, not worsen.

Basically, when I prescribe herbal medicines it is my expectation that, upon the first 2 week follow-up appointment, noticeable improvements should be seen. Sometimes improvements take longer, even up to 8 weeks for such stubborn conditions as psoriasis, but I never really like to see a condition worsening. If a condition does worsen then it possibly tells me a few things:

Steroid use: Depending on how much and how often someone has used steroid creams, the skin may flare up when they are stopped. This is because steroids only suppress inflammation, they may not completely get rid of it. The ‘rebound effect’ is a well know experience for people stopping steroids, whereby the skin flares up again, sometimes even worse then before. This is not due to herbal medicines, but rather the body not knowing how to fend for itself anymore after being so strongly suppressed with the steroid. Given enough time, most patients are able to transition over to herbal medicines, finding that their skin begins to clear even better than when they used the steroid.

Wrong treatment: Herbal medicines are custom fit to the individual and may not actually be the right ones for you. There are many herbs to choose from, and even more combinations for those herbs to be mixed together. If the herbs are the wrong fit for the person, then a worsening of their condition may be experienced. It may also be that the herbs were just not strong enough to control an already in progress flare up, and thus a bigger dosage is needed. If I see this happen, then it gives me much information as to how to redesign the next herbal prescription. Medicine is an art, and hence why we call it the ‘practice of medicine’. Finding the right fit for the individual may take a couple tries, but once it is found, results are seen.

Coincidence: Sometimes other factors in ones life – like alcohol drinking, stress, over-eating of sugary or deep-fried foods, or applying certain kinds of moisturizers and make-up – may coincide with a flaring of the skin. If we don’t pay attention it would be easy to assume that this was due to the herbal medicines, but in reality it was due to other factors. Sometimes we cannot even figure out what the culprit is that is influencing the skin to flare, as is the case in some people with environmental allergies to things like dust or pollen, and so we just have to keep plodding through with treatment until the skin comes under control, refining the prescription as needed.

Of all the conditions that I treat, Acne is one that may get a bit worse before getting better. Some people whose acne tends to be rather deep-seated, rarely coming to a head, may find that as their acne clears they have more pustules – ie. that their acne comes to a head more often. This is a good thing, as it shows that the acne is improving by becoming less deep, and would not be considered a worsening. Overall, I would say that when you start a treatment you should see your condition progressively improve, not worsen. So again, when I treat skin conditions with Chinese herbal medicine I am NOT looking for any healing crisis! (Please read enough is enough for more for treatment expectation ideas)

Ahhh.. Chocolate. Sweet intoxicating richness – the inspiration of romantics for centuries. Certainly you made the perfect valentines day gift yesterday, for which I am sure many a happy face was created. In 1796 a Spanish army surgeon said it all, ‘Chocolate is a divine, celestial drink, the sweat of the stars, the vital seed, divine nectar, the drink of the gods, panacea and universal medicine.’ So good are chocolate’s health benefits, for now modern science is even proving them to be true!

But before we proceed a step further lets discuss the kind of chocolate that is good for you, as it is certainly not the average overly-processed stuff found in most candy aisles. Healthy chocolate is at least 60 to 70%dark chocolate. Most candy bars do not even contain much real chocolate in them at all, being mostly filled with refined sugars and poor quality fats, so it pays to read the label. It is also good to seek out chocolate that is both organic, thus avoiding harmful chemicals, as well as fair-trade so as to guarantee that the farmers are getting paid well for their efforts.

Dark chocolate is a very nutrient dense food, containing many important vitamins and minerals such as vitamins A, B1, B2, B3, C, E, pantothenic acid, magnesium, calcium, iron, zinc, copper, potassium and manganese. It is composed of about 20% protein and upwards of 50% good quality fat. Chocolate is also rich in powerful antioxidants, called flavanols, which may help improve blood circulation. The list of health benefits from chocolate includes: better heart health, lower blood pressure, reduced risk of stroke, improved cholesterol profiles, and a smarter brain.

In regards to skin health, studies have shown that regular chocolate consumption: softens the skin, protects the skin against the damaging effects of the sun, improves microcirculation to the deeper layers of the skin, rehydrates the skin, and improves the overall cosmetic appearance of the skin – thus giving it a nice radiant look. But again, these benefits come best from good quality dark chocolate, not those overly-sugared candy bars.

In the creams that I personally hand-make for patients, I will often use cocoa butter, usually combining it with shea butter. These two saturated plant-based fats create a fantastic barrier that helps lock moisture into the skin, while also offering nourishment. This means that cocoa based creams can help alleviate and prevent the dryness seen in many skin conditions such as eczema and psoriasis. In contrast, petroleum based products – such as vaseline – offer no nourishment whatsoever, and in fact may occlude the skin too much so that it cannot breathe properly.

So how much chocolate does one need to eat in order to obtain the healthy benefits? Well, research seems to indicate that about 50 grams per week of good quality 70% dark chocolate is enough, which is about half of a standard sized bar like Green and Blacks, or Camino (both companies use fair trade and organic chocolate). Basically, chocolate is best used as a small enjoyable supplement alongside a properly balanced diet containing a wide variety of fresh colourful vegetables, whole grains and quality proteins.

Well they didn’t actually invent the apple, as that was the work of Mother Nature, but it is very possible that the Chinese first invented the method which allowed us to grow apples as we know them. Grafting, the art of attaching one variety of apple to another variety, allowed us to consistently eat a macintosh, or a gala, or a fuji, etc. Basically, if we try to grow an apple tree from seed we would probably end up with something random, perhaps something a bit reminiscent of the wild crab apple. Grafting allowed for the consistent production of a predictable apple variety, a genius invention to say the least!

The history of grafting is a bit obscure, as references to the technique exist in both ancient Greek and Chinese literature. However, there is a trend amongst historians to place the Chinese as the first to invent grafting, as is suggested by the authors of the informative paper ‘The history of Grafting’:

“Whether the Chinese and Greek references to grafting represents separate independent ‘‘inventions’’ or more likely an Asian discovery that migrated, East and West, along with other components of agricultural technology (Carter 1977)…”

Simon Winchester, the author of Joseph Needham‘s biography entitled ‘The man who loved China”, shares a quote from Needham’s diary about watching a Chinese man graft a plum tree – an act that may have first ignited Joseph Needham to start writing his epic 24 volume work entitled ‘Science and Civilization in China‘. Winchester writes, ‘He had evidently stopped to watch this old gardener, not just because of the man’s exotic appearance. He had realized that in following as closely as he could the manner in which the man was splicing, tying, and grafting the plum tree, he was actually witnessing something rather important. He was watching a performance – the carrying out of a technique, a craft, a science – that was … thousands of years old’ (Winchester, 2008).

So why I am writing about the Chinese inventing grafting, or even apples for that matter? Well for two reasons really:

Apples are fun to grow! This last march, 2012, I grafted 30 apple trees myself (first time I tried) with big plans of building an espaliered apple fence! Well 18 of them took very well, and I am now prepping the bed and frame work so that I can plant them in the next couple weeks. This ‘apple fence’ will line the drive way of my home, which is also where my clinic is located, and as such has everything to do with my practice of Chinese medicine!

The apples trees that I grafted (Pictures taken in June, 2012)

This is one of the apple fences displayed at UBC’s botanical gardens (picture taken during the apple festival, Oct 2011)

Usually following a strep throat infection, guttate psoriasis can manifest with widespread, small, tear-drop shaped lesions that are red, raised and scaly. While nasty looking, it is generally thought that guttate forms of psoriasis will usually clear on their own within a few weeks, or months. The problem is that for some individuals guttate psoriasis may also become chronic, even lasting one’s entire lifetime. So do we wait and see what will happen, or do we treat proactively in order to help prevent this condition from sticking around.

Personally, I like to treat. The problem with statistics is that no one can say whose guttate psoriasis will clear on its own, and whose will not. This seems to be a completely random experience for individuals and thus I think treatment is important. Chinese herbal medicines can be particularly effective at clearing psoriasis, especially the guttate forms, and should be looked at as a primary health option – that is, of course, with a doctor skilled in using herbal medicine for the treatment of psoriasis.

In my training and experience I have seen good results using the treatment principles of cooling blood, resolving fire toxins, and scattering wind. These are basically Chinese medical terms indicating which herbal medicine categories to choose from. Many of these Chinese herbs are found to be effective at clearing common oral bacteria, like streptococcus, and as such help rid the body of the infective aspect contributing to the psoriasis. I like to use raw herbal medicines, as I find their strength the best in these often stubborn situations. I also like to use externally applied herbal creams and salves, as the most effective way to treat most skin disease is truly done by working from the inside and out.

Recently I have been working with a young boy who developed guttate psoriasis a few months before coming to see me. His doctors had said that it would go away on its own, but there was no real evidence of this happening. Actually the psoriasis lesions were worsening – growing in numbers, enlarging, and connecting together to form plaques. They were also extremely itchy. This boy actually had a history of some previous psoriasis on his scalp and arms, making me think even more that his condition was unlikely to improve on its own. He was also using a variety of different steroidal creams that did not seem to be giving him benefit.

I prescribed him some herbal medicines based on the principles I outlined above, which he was very eager to try. At his two week follow-up appointment I was impressed to see that he had actually cleared by over 60%. He was no longer itchy and was finding the tea not to difficult to drink (although he did complain about the taste a bit). Below you can see some cropped aspects of his back and chest. The white areas are called post-inflammatory hypo-pigment, and are left over from the past psoriasis lesions disturbing the normal melanin production in that area. These white spots will most definitely go away on their own over time.

Guttate psoriasis of the Chest – Before herbal medicine treatment

Guttate psoriasis of the chest – 2 weeks into herbal treatment

Guttate psoriasis of the back – before treatment with herbal medicine

Guttate psoriasis of the back – 2 weeks into herbal treatment

Within 2 weeks of ingesting herbal teas that were specially crafted for this individual we can see more than 60% reduction in his psoriasis, including the disappearance of a relentless itch. It is obvious that this boy has received tremendous benefit from properly prescribed Chinese herbal medicines.

You know that saying, ‘The whole is greater than the sum of its parts’, well physicians of Chinese medicine have historically always utilized this idea when prescribing herbal medicines. It is well known that herbs work better in pairs or, better yet, in formulations of many herbs. Now even the modern scientists are noticing this to be true, for research is showing that when herbs are combined together their ability to fight disease is much greater than if the herbs were used alone. The important part is that the herbs need to be cooked together.

Seems, a bit Harry Porter really doesn’t it? I mean mixing a bunch of roots, leaves, fruits and seeds into a pot, boiling them away for half an hour, and then straining off some horrid tasting liquid is all a bit witchcraft and ferry-tale right? Why bother? Why not let the scientists investigate what the main active chemicals in the plants are and extract them. Put it all in a nice little pill and away we go. Cooking plants together seems so primitive doesn’t it.

Actually, this ancient art of cooking herbs together is being shown over and over again in laboratory settings to be a very important step. It seems that newer and more complex chemicals are formed when herbs are cooked together, ones that have profound effects. For example, when investigating the anti-inflammatory and anti-bacterial actions of the two herbs, Ku Shen (sophora flavescens) and Dang Gui (angelica sinensis), researchers found that they worked much better as a herb pair, rather than as isolated herbs. As a team, these two herbs had a much stronger effect at clearing such pathogens as E. coli, Staphylococcus aureus, and Shigella Castellani and Chalmers, while inhibiting the production of toxic inflammatory cytokines, including IL-1β, TNF-α, iNOS, ICAM-1, and COX-2. The researchers thus concluded that, “The study supports the hypothesis that the anti-pimple and anti-eczema activities … are attributed to herb pairs, A. sinensis and S. flavescens, used in combination”.

In another study, which was looking at the complexity of Chinese herbal medicine formulae, researchers found many interesting things with the 800 year old formula called Dang Gui Bu Xue Tang, which contains just two herbs: dang gui (angelica sinensis) and Huang Qi (Radix Astragali). Certain chemicals found within each herb were more available, with increased solubility and less oxidative destruction, when cooked together. This study looked even further than chemicals within the herbs, it actually looked at gene expression in individuals taking this medicine, finding that changes to at least 403 genes were specific to the herb pair, compared to using just the individual herbs used alone. Basically the herbs worked better when combined together.

Actually, the formula Dang Gui Bu Xue tang is traditionally used for those suffering with blood loss, who are weak and depleted. Researchers have found that this formula has the ability to increase hematopoiesis, which is the ability for the body to make more blood cells. A couple years ago, I had a patient who lost a lot of blood during the delivery of her second child. She came to me with a haemoglobin level in the 70’s, having a very pale and white complexion (even her palms were pale!). She was obviously told that a blood transfusion would be needed as she had severe anemia. She refused the transfusion and so I prescribed Dang Gui Bu Xue Tang (with some other herbs added) and within one week her haemoglobin jumped up to 110, which is basically 4 units of blood! This patient was actually a GP and was obviously very impressed, saying that there is no western medicine drug that can do such a thing.

Herbs are powerful, especially when they are cooked together. Need I say more…

Many skin disorders can look alike and, as such, it takes a well trained eye to determine exactly what is taking place on the skin, and even then a second or third trained eye may be needed. I often run into cases where I encourage the patient to see another physician, especially in cases where the diagnosis seems somewhat hazy, or is something that I am not comfortable treating – skin cancer being one of them! In the past year alone, I have encouraged at least 4 different individuals to see western trained dermatologists as I was certain that they had something different than what they thought.

The first two patients had been told by previous practitioners, both western MD’s and alternative natural doctors, that they had psoriasis, which was clearly not the case. While psoriasis can be tricky to diagnose from time to time, it usually presents with a fairly identifiable pattern that both of these patients did not have.

For the past 20 years, the first individual had a sore on only one side of his chest, an obvious red flag that it may be something other than psoriasis, as psoriasis is usually symmetrical. To make matters worse, the sore was ulcerated and would ooze yellow fluid, which is also not characteristic of psoriasis. I suspected a condition called paget disease, which I knew could become cancerous. I encouraged this man to have a biopsy through a western specialist and sure enough he did have cancer. Luckily the cancer had not spread too deeply into the surrounding tissue, which is somewhat of a miracle considering the length of time he had it – 20 years!

The other individual had many random red and raised spots all over his body, which all had a yellowish scale. He told me that he was a sun lover for many years, a fact that helped confirm that he had a condition called actinic keratosis, or solar keratosis, which is a condition that arises from sun damage. Upon closer examination I noticed that many of them were bleeding and ulcerated, taking a long time to heal, which led me to think that these may be squamous cell carcinoma – a common evolution of the actinic keratosis. I encouraged this man to see a western dermatologist to confirm diagnosis and to offer treatment, as I believe one of the best ways to rid oneself of this type of cancer is surgical.

The third patient that I referred on for further examination was actually a group of 5 people – a new mother, her mother, her infant son, her father, and her husband. All of them had somehow developed a ‘mysterious’ and itchy rash 6 months previously, right around the birth of the infant. The general physician who saw them thought that the new mother may have had scabies, but changed his mind when she did not seem to respond to the medicines he prescribed to her. He declared that infants do not get scabies, so must have eczema, and prescribed a topical steroid. No diagnosis was given for the others. A referral was put in to see a western dermatologist which, due to our long back list in British Columbia, was in another 6 months time. Upon investigation I diagnosed scabies, in fact I thought it to be one of the worst cases I had ever seen, taking note that it was probably the infant that was actually passing it around when everyone would hold him. I encouraged this family to go straight to the hospital emergency and tell them what I found, for which they did that same day. The on-call emergency dermatologist agreed with me and was thus able to offer swift treatment, a much appreciated move as I could not imagine them living with this condition for another 6 months!

The last case, for which I encouraged a referral, did indeed have psoriasis, which responded very well to Chinese herbal medicines. The problem was that there was a solitary lesion on the patient’s neck that did not respond and upon close examination looked suspicious with tiny blood vessels growing in it (another red flag that could indicate basal cell carcinoma). To be safe I encouraged this patient to seek the advice of a western trained dermatologist, for which we are still waiting for feedback.

Misdiagnosing is common, but preventable. The main part is to become knowledgeable with what common skin disorders look like, so that when something appears differently than the norm we can ask for other opinions. The very first text book dedicated to dermatology in Chinese medicine, the Liu Juan Zi Gui Yi Fang (Liu Juan Zi’s Formulas Inherited by Ghosts, 479 to 502 AD), explicitly explains how some sores found on the body are associated with death, or are not treatable, and so again pointing out the importance a correct diagnosis!

One of the biggest obstacles for people taking herbal treatments is the taste. Some people simply cannot stomach up enough courage to make it through the first few days of treatment, especially children. They lack the foresight to see that once the taste buds adjust to these foreign flavours, after a couple days or so, things get much easier. But today I saw something different. My little ten year old patient, who started treatment two weeks ago for the treatment of psoriasis, came in for his follow-up declaring that he had finished off all the herbal teas that I had prescribed.

I was actually very impressed, and told him so, saying “You are very brave for taking those medicines. Many adults cannot even take them!” Then when I looked over his skin I noticed something remarkable, his psoriasis was at least 60% better, and only in 2 weeks of treatment. I told him, “Your skin has improved greatly, and that is mostly because you had the courage to drink your medicine! Good for you!”… (His mother later told me that the little guy really had no choice in the matter, he was going to take his medicine!)

Nonetheless, results are as much a part of the correct diagnosis and treatment plan, the correct mix of herbal medicines, as they are to the compliance of the patient. So there you go, if a ten year old can muster up the courage to take the treatment, and see good results, then so should anyone right!

That is exactly what I asked my wife Gillian Allan, a registered Midwife, way back in 2001 when we first met. Gillian had been suffering with allergic eczema, asthma, hay fever, and chronic hives for most of her life. Her response back to me was that she had tried everything, had spent hundreds of dollars on “alternative” medicine and had now come to a place in her life where she needed to just accept her fate.

Western medicine, with its basis in biochemical pharmaceuticals had basically written Gillian off. They had told Gillian that her only relief would be found in topical steroid creams, but that because her eczema was so wide spread she needed to apply them very sparingly and carefully, as the side effects could be very detrimental to her. Basically they had told Gillian that there was no cure for her eczema and that she would suffer with it for life.

Gillian, being a very proactive rebel, was not prepared to accept what these Doctors were telling her. She jumped into the arena of alternative medicine with full gusto, trying everything from elimination diets to energy healing to homeopathic remedies. But to Gillian’s disappointment, she was still suffering. Her skin was the same – red, inflamed and extremely itchy. All the hundreds of dollars that she had spent over years of experimenting had not worked. This is about the time when I met Gillian.

So I said, “You know, Gillian, Chinese medicine is very different than all the other things you have tried. Chinese medicine looks at your body in a different way and has a long track record, thousands of years in fact, of success. Why not give it a go?” Gillian, holding out her dry sand-paper like arms to me, said “Trevor I have tried everything, I need to accept the fact that I have eczema. My skin is the way it is, horrible!”

Well, I am also quite the proactive rebel and so persisted for the entire first year that we dated to encourage Gillian to give Chinese medicine a try. Eventually she gave in and we made the journey to visit my first mentor Dr. Kingson Wu, who after closely examining her, prepared a mix of herbal remedies for Gillian to take home and drink.

The herbs tasted awful, but the one thing I love about Gillian is that whatever she commits to she persists with. Gillian had a focus, which was to heal her skin. She had made a decision to try something different and she was not about to give up because of a bad taste!

Good thing for Gillian’s persistence, as 3 months later she was eczema free – for the first time in her life! Now when Gillian would hold out her arms to me, instead of sandpaper there was normal, moist and supple skin. Gillian was so excited and would exclaim “I have normal skin! I have normal skin! Trevor, feel my skin. It is actually soft!”

Gillian continued to take herbal medicines for about a year and a half. Not only did her eczema clear up, but so did her asthma (which used to be triggered from such simple activities as climbing a hill in the cold air) and her hay fever (which usually entailed a morning ritual of cleaning up the hundreds of tissue papers left beside the bed after a night of non-stop drippy nose!). Now, being 2011 and almost 10 years after Gillian stopped taking the herbal remedies she is doing great. She has not had any eczema since.

So instead of being the husband with the know-it-all attitude of “I told you so”, I decided it would better for me to learn how to treat others who were suffering in similar ways to Gillian. I dedicated my life to learning Chinese medicine, particularly in the area of dermatology. It was seeing first hand the amazing results that Gillian experienced that motivated me to study all over the world, gaining the knowledge base that I now have. It has become my greatest pleasure to see Gillian’s story repeated through the lives of others.

I recently had an eight page article published in the prestigious Journal of Chinese Medicine (JCM) on the importance of defining the correct disease name. Although it will mostly appeal to other practicing doctors, some non-health care professionals may enjoy the piece as well. In the article I present historical evidence of doctors treating well defined skin disorders since at least 300 bc. I then list several examples from my own clinic as to why the correct disease diagnosis is crucial in achieving a good outcome.